96-531Council File # � ' S '
�'�i't?�i����
ordinance #
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
Presented By
Re£erred To
Green Sheet #
v�7
1
2
3
4
RESOLVED: That application, ID #18316, for a new Ga�:
Jon Burlingame DBA Minnesota Recreation a:
Schally's (Eormerly I,entsch's), 1091 Rice
hereby approved. �
Manaqer's License by
: Association at
, be and the same is
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Requested by Department of:
Office of License, Inspections and
Environmental Pxotection
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Form Rpproved by City Attorney
Adopted by Coun 7
Adoption Cert'fiec
By:
Approv by Mayor:
By:
. Date
by Council Secretary
Date
✓ � By: C�C
Approved by Mayor for Submission to
Council
By:
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FOii
TOTAL # OF
PAGES
q�,�s3 t
GREEN SHEET N 34941
INfT1AUDATE INff1AUDATE �
DEPAHTMEMDIRECTOA �CT'COUNCIL
CITY ATfORNEY � CIT' CLERK
BUDGET DIPEGTOfi � FIN. 8 MGT. SERVICES Olp.
MAYOR (Ofi ASSIS7ANTJ �
(CLIP ALL LOCATIONS FOR SIGNATURE)
Jon Burlingame DBA Minnesota Recreation and Park Association requests Council
approval of his application for a new Gambling Manager's License, ID f{18316, at Schally's
(formerly Lentsch's), 1Q91 Rice Street.
RECOMMENDAT10N5: Approve (A) w Reject (i�
_ PLANNING COMMISSIDN ___ GYIL $ERYICE COMMISSION
_GBCOMMfiTEE _
_ STAFF _
_. DISTRICT CAURT _
SUPPoRTS WHlGH CAUNCILOBJECTIVE?
wn�, wnan,
PERSONAL SERVICE CONTHACTS MUST ANSWER THE FOLLOWING QUESTIONS:
7. Has this pewONfirm ¢ver Worked under a cOntrdct for this tlepartme�t2
YES NO
2. Has this personftirm ever been a city empfoyee,?
VES NO
3. Does this per5on/firm possess a skili not normatly po5sessed Dy any curreni city employee?
YES NO
Explain all yes answers on separate sheet and attaeh to green sheet
wny>:
fFAPPROYED:
�s;�,� i `� '��4'f� '��$�'f
l;�r`;,� �.n; .�u'�
�TALAMOUNTOFTRANSACTION $
COSVREVENUE BUDGETED(CIRCLE ONE)
YES NO
NOIfdG SOURCE ACTIVITY NUMBER
ANGIAL INFORMATION' (EXPLAIN)
Greensneet # 34941 L.I.E.P. REVIEW CHECKLIST Date: [ QG"53 �
In Trackei'? 3�-3 �i� app'n f3ece�vad / n�p�n �acessed
License 1D # 18316 License Type: Gambling Manager
Company Name: Jon Burlingame pgA: Minnesota Recreation and Park Assoc.
Business Addresss: 1091 Rice Street Business Phone: 920-6906
Contact Name/Address: 5005 West 36th St. Home Phone: 920-6906
Date to Council Research: St. Louis Park, MN 55416
Pubiic Hearing Date: � 2 i 194� Labeis Ordered:
Notice Sent to
Notice Sent to Public:
Date
District Council #: 6
Ward #:.
Comments
City Attomey
Environmental
Health
Fire
License
° O�ICQ
�1�7�96
Site Plan Feceived_
Lease Received:
�'�pp� �hec�C.
�ning
Minnesotc Lau;ful Cambttr�g
Gambling Manager Application
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❑ Renewal
Ciry/State
rt
Address
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FEE
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DATE
INIT
License Number
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2ip Code Phone
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-• A;t 0,000 fWeliry bond in iavor ot tha oryanizaCOn must be obfained lo� d�e gambGng manager.
Name of insurance company (do not use agency name) �s� r�' h— Me: le. i•'� S. ep, gond Number ��I — b6" ��'
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1 dedare tliat:
• i have read this appGcatlon and al� infortnadon submitted to tlia board;
• all inlortnaCOn is trua, accurate and complete;
• all other required infortnation haz been (ulty disdosed;
• I am the onry pambting manager of tha aganiza6on;
• 1 wiU familiarize myself with the laws ot hGnnesota goveming Iawful garnbling and rules oi Ihe board and agrea, if Gcensed, to
abide by those laws and rulas, induding amendments ro them;
• any changes in appiication information will ba svbmirted to the board and bcal unit of govemment wiCiin 70 days of the changa;
• Rn a�dadt tor garn6ling maoager has 6een completed and aaached, and
• t understand that failure to provida required information or providing false intorma6on may result in the denial or revocafion ol �he
license.
Signatura of Gambling Manager
Data
3_�- �i
Send the cor(y(Isted application and a{t requfred attacfimants to:
Gambling Contro! Boatd
Sufte 3D0 S.
17i1 W. County Road H
Rosevllle, MN 551 t3
Give date that the two-day pamb6rp man�er seminar wes oamPleted• _.J /�J 9S
�Loca6on Cf traininy 12 cSt.J, lle.
(dH>
Gitie date of bainirg received within thrae years prior io the date of the appGcaEOn for renewal. / /
Lemfia� nf trainina
t�3%�
MEMBERSHIP: Data yamb6rp manager Decame a member o1 rha orgaruzation �t l i� Sex : j$1 Mate ❑ Femaie